Fruit and vegetable consumption and exercise frequency can
be increased by participation in a health promotion intervention designed to
reduce the risk of chronic diseases, investigators report in the April 25th
edition of the Archives of Internal
The research involved African-American HIV-serodiscordant
heterosexual couples who were randomised to receive either information and
motivation about the benefits of good diet and exercise, or a general
HIV/sexual health promotion intervention.
Up to a year after completing the programme, couples participating
in the healthy living intervention were significantly more likely to report
eating a diet rich in fresh fruit and vegetables and regular exercise.
Moreover, participation in the enhanced health promotion
information was associated with the consumption of less fatty food, and
increased rates of screening for prostate and breast cancer.
“The present results demonstrate that a health promotion
intervention had significant effects on multiple health behaviors in African-American HIV-positive and HIV-negative individuals,” comment the investigators.
The author of an accompanying editorial was “particularly impressed with the
Chronic conditions such as cardiovascular disease are now an
important cause of illness and death in people with HIV. Therefore, addressing
modifiable risk factors for such illnesses is now an important priority of HIV
African-Americans represent 48% of all HIV-positive patients
in the US, and African-Americans generally eat fewer fruit and vegetables,
exercise less frequently, and have poorer survival rates for prostate and
breast cancer than white Americans.
Investigators therefore wished to see if an intervention could
improve a range of health behaviours in HIV-serodiscordant African-American
couples enrolled in an HIV/sexual health promotion study.
The study was conducted between 2003 and 2007. The
intervention consisted of eight two-hour weekly sessions and was designed to
build skills and knowledge about eating lots of fruit and vegetables, exercise,
the reduction of fat in diet, screening for prostate and breast cancer, and
A total of 550 individuals were randomised to receive the
intervention, and 520 individuals were randomised into a control arm, and
received HIV/sexual health information. Outcomes were monitored six and twelve
months after completion of the trial.
At baseline, only 21% of participants overall reported
eating five or more portions of fruit and vegetables a day, and fewer than 20%
Six and twelve months after completing the study,
individuals in the intervention arm were 38% more likely than those in the
control arm to report having a diet that incorporated large amounts of fruit
and vegetables (odds ratio [OR] = 1.38; 95% CI, 1.18-1.62, p < 0.001). Patients
in the intervention arm were also significantly less likely to report the
consumption of fatty foods (p = 0.003).
They were also 39% more likely to report regular exercise
(OR = 1.39; 95% CI, 1.22-1.59, p < 0.001).
Rates of prostate and breast cancer screening were also
significantly higher in the intervention arm (p < 0.001 and p = 0.009
However, alcohol consumption was comparable in the two arms
of the study. The investigators speculate that this was because individuals in
the control arm received information about the role of alcohol in HIV risk
“We are optimistic that the present study offers an approach
that may help reduce the disproportionately high morbidity and mortality rates
from chronic diseases in African-Americans,” conclude the authors.
In his accompanying editorial, Dr Mitchell H. Katz of the Los
Angeles Department of Health described the intervention as “highly feasible”,
adding that although it was conducted in serodiscordant couples, “there is no
reason to believe that [the] intervention would not work among HIV-infected